Diferencias relacionadas al sexo en pacientes con infarto agudo de Miocardio ST Elevado

Objective To determine the epidemiological characteristics, location of the infarction, type and times of reperfusion, as well as in-hospital adverse events, distributed by sex in patients with ST-segment elevation myocardial infarction (STEMI) in Peru.

Methods It is a sub-analysis of the PEruvian Registry of ST-segment Elevation Myocardial Infarction (PERSTEMI), which was an observational, prospective and multicenter study about patients over 18 years-old, who were hospitalized for ST-segment elevation myocardial infarction. Epidemiological and clinical characteristics, management and in-hospital adverse events were compared according to sex.

Results 396 patients were studied, 20.9% were female, with a predominance of octogenarian population over men. High blood pressure was the most frequent risk factor in women (74.7 Vs. 50%, p = 0.001); as well as atypical clinical manifestations such as dyspnea (40.9 Vs. 27.1%, p = 0.012) and syncope (10.8 vs. 3.8%, p = 0.017). On the other hand, the inferior wall myocardial infarction was more frequent in women (51.8 vs. 38.98%). There were no significant differences regarding the reperfusion therapy used (Fibrinolysis, primary PCI, PCI in general); as well as in times of ischemia (6 vs. 5.6 hours, p = 0.456), reperfusion times and hospital stay between both sexes. However, the female sex presented higher in-hospital mortality (21.6 vs. 7%, p = 0.001), mechanical complications (8.4 vs. 1.9%, p = 0.008), cardiogenic shock (15.6 vs. 9.5%, p= 0.087) and heart failure (33.7 vs. 24.9%, p = 0.072).

Conclusions STEMI in females presents at significantly older age compared to males and is associated with higher in-hospital mortality and mechanical complications.